POS1370 METABOLIC SYNDROME IS ASSOCIATED WITH MORE PAIN IN HAND OSTEOARTHRITIS: RESULTS FROM THE DIGICOD COHORT
Authors: A. Charton, R. Lacoste Badie, S. Tuffet, A. Rousseau, E. Maheu, B. Fautrel, M. Dougados, F. Berenbaum, A. Courties, J. Sellam
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> While association between metabolic syndrome (MetS) (combining central obesity, diabetes, dyslipidemia and/or hypertension) and the risk of osteoarthritis (OA) disease risk remains controversial at the structural level, MetS could be involved in OA-related pain. To analyze such an association, investigating hand OA is more relevant than knee OA to avoid the strong influence of weight on bearing joints. <h3>Objectives</h3> To determine whether the presence of MetS is associated or not with a higher pain level in hand OA. <h3>Methods</h3> This cross-sectional study involved patients included in the hospital-based hand OA DIGICOD cohort, for whom all baseline variables of interest were available (NCT01831570). The characteristics were described and compared according to the presence or absence of MetS (Adult Treatment Panel III criteria). We searched for an association between MetS and several outcomes measuring different aspects of OA-related pain (hand pain intensity using visual analog scale (VAS) on activity, VAS pain at rest, hand pain in various situations using the self-reported Australian Canadian Osteoarthritis Hand Index (AUSCAN) pain subscore, Arthritis Impact Measurement Scale (AIMS2) pain subscore assessing the OA pain nonspecifically related to hands, number of painful hand joints on pressure) using 2 logistic regression models: model 1: adjustment for age, sex, and the radiological Kellgren-Lawrence (KL) total sum score. model 2: model 1 + hospital anxiety and depression (HAD) scale. All pain outcomes were binarized by their median values defining thus high and low pain levels. Results are presented as odds ratios (OR) with 95% confidence intervals (CIs). The reference group was "no MetS" (MetS-). <h3>Results</h3> A total of 359 patients (85% women, 66.3±7.4 years) were analyzed out of 425 included, including 128 (36%) patients with MetS (MetS+). The 2 groups (MetS+ and MetS-) did not differ in their demographic characteristics except for BMI (27.1±4.5 and 24.0±3.8 kg/m<sup>2</sup>, p&lt;0.0001), age (67.9±7.1 and 65.5±7.5, p=0.003), KL sum score (48.9±17.7 and 44.5±17.5, p=0.03), and HAD (13.7±6.7 and 12.1±5.7, p=0.02) (Table 1). MetS was associated with a higher VAS pain at activity (median: 44/100) in model 1 (OR=1.63, 95%CI (1.04; 2.56), p=0.03) but this association was attenuated with further adjustment on HAD scale (OR=1.48, 95%CI (0.94; 2.35), p=0.09) (Table 1). MetS was also associated with a higher AUSCAN pain (median: 20/100) in non-adjusted analysis but this did not persist in adjusted model 2. No association was found with VAS pain at rest or the number of painful joints on pressure. MetS was associated with a higher AIMS2 pain subscore (median: 33/100) in both models (OR=1.70, 95%CI (1.06;2.74), p=0.03). <h3>Conclusion</h3> MetS was associated with more hand pain in hand OA, partly mediated by anxiety-depression. MetS also increased the risk of OA pain nonspecifically related to hands suggesting a higher susceptibility to joint pain in general in patients with MetS. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.